Medications for End-stage Renal Disease (ESRD)

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

If you have
high blood pressure
,
hyperlipidemia
, or
diabetes
, medications will likely be ordered to control these conditions. Leakage of protein from the urine is treated with two drugs used in the treatment of high blood pressure: angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). In addition, medications may be needed to treat complications of kidney disease. There are no medications to cure or reverse kidney failure.

Over-the-Counter Medications

Prescription Medications

Cinacalcet HCL

Common name:
Sensipar

In chronic renal disease, a disturbance in calcium, phosphate, and vitamin D metabolism leads to a condition called secondary
hyperparathyroidism
. It is characterized by abnormally high levels of parathyroid hormone (PTH) in the blood. The high PTH levels lead to uremic bone disease. Cinacalcet HCL is effective in lowering the elevated PTH levels in chronic renal failure patients. It is taken by mouth.

Possible side effects include:

Nausea

Vomiting

Transient low blood calcium level

Diuretics

Furosemide
(Lasix)

Bumetanide
(Bumex
)

Diuretics help rid the body of excess fluid. These medications are sometimes referred to as water pills. Diuretics may be taken by mouth or, in some cases, by injection.

Possible side effects include:

Lightheadedness

Mouth dryness

Weakness

Frequent urination

Sevelamer

Common name: Renagel

This agent, which is taken by mouth, binds phosphate to prevent increased blood phosphate levels that can lead to weakening of bones. The medication does not contain calcium, aluminum, or magnesium.

Possible side effects include:

Nausea

Diarrhea

Upset stomach

Recombinant Human Erythropoietin (Epoetin Alfa)

Common names include:

Epogen

Procrit

This drug is injected and used to treat anemia associated with renal failure. It stimulates the production of red blood cells.

Possible side effects include:

Headache

Increased blood pressure

Joint aches

Nausea

Over the Counter Medications

Sodium Bicarbonate

Typically taken orally, sodium bicarbonate may be ordered if you develop a condition called metabolic acidosis. This is an excess of acid in the blood due to alterations in metabolism from kidney failure.

If you need to use sodium bicarbonate, you should review your dietary sodium intake with your physician or dietician. This medication will increase the sodium in your diet.

Calcium Carbonate or Calcium Acetate

Calcium supplements are given to bind phosphate to maintain phosphate levels within a range that will not increase bone loss. These drugs are taken orally.

Possible side effects include:

Constipation

Loss of appetite

Slow heart rate

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:

Take your medication as directed. Do not change the amount or the schedule.

Do not stop taking them without talking to your doctor.

Do not share them.

Ask what the results and side effects may be. Report them to your doctor.

Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.

Plan ahead for refills so you do not run out.

When to Contact Your Doctor

Call your healthcare provider if you develop side effects from the medications or you have:

Signs of infection, including fever and chills

Nausea or vomiting

Abdominal pain

Lightheadedness or weakness

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.